Allografts known as acellular dermal matrices, or dermices, are used in the field of soft-tissue replacement. In breast reconstruction, an acellular dermis acts as a sling to support tissue expanders or implants. This acellular dermis improves inframammary fold definition, implant coverage (for example sufficient skin tissue thickness so that the implant cannot be discerned), and aesthetic appearance.
Acellular dermis is known to have different forms, which include a fully hydrated human-derived form, a freeze-dried or solvent-dried human-derived form, and a porcine-derived form. Commercial examples include FLEXHD®, a fully-hydrated human-derived dermis presently available from Ethicon; ALLODERM®, NEOFORM®, and DERMAMATRIX®, which are dehydrated human derived products available from LifeCell Corp., Tutogen Medical, Inc., and Synthes CMF respectively; and PERMACOL® and STRATTICE®, porcine-derived products available from Coviden Surgical and LifeCell Corp. respectively.
In light of their allogeneic or xenogeneic nature, these known acellular dermis products may transmit disease from the host, thereby causing complications such as inflammatory reactions. Additionally, the acellular dermis products must be sterile, and the specialized processes to produce the sterilized products are known to have errors that permit contamination. Also, these biologically based acellular dermis are very expensive due to the costs for harvesting, sterilizing, and storing the tissue. Newer products that utilize alternative sources of dermis are known, but still have price points comparable to human dermis.